Healthcare Provider Details

I. General information

NPI: 1841372802
Provider Name (Legal Business Name): RONALD WILLIAM SAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BUTTE ST
REDDING CA
96001-0852
US

IV. Provider business mailing address

1321 BUTTE ST # 202
REDDING CA
96001-1034
US

V. Phone/Fax

Practice location:
  • Phone: 530-949-2259
  • Fax: 530-229-3703
Mailing address:
  • Phone: 530-246-5710
  • Fax: 877-554-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG59979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: